An Introduction to Concussion Recovery:
Please note that I am not a medical professional. My goal is to help spread awareness about concussion recovery and aid in facilitating conversations between concussion & traumatic brain injury survivors and their healthcare providers.
A Basic Outline of Concussion Types & Potential Treatment Providers
According to this article from the National Library of Medicine, The 7 Clinical Phenotypes of Concussions** that warrant the need for evaluation and potential treatment can be described by this acronym: COACH CV (outlined below). I’ve included notes with suggested treatment providers I’ve discovered on my journey with help from resources posted by TBI Survivor Molly Parker, PT, DPT.
C: Cognitive Function
Common symptoms: memory problems, decreased attention, difficulty concentrating, slowed mental processing speed. Emotional function should also be assessed by your doctor.
Treatment Providers: Speech Therapist, Occupational Therapist, or Neuropsychologist.
O: Oculomotor Manifestations (Visual)
Common symptoms: problems with visual pursuit, convergence, screen viewing, and light sensitivity. It may be necessary to get a referral to an eye doctor an optometric assessment.
Treatment Providers: Neuro-Optometrist, Occupational Therapist, or Physical Therapist with training in vision.
A: Affective Disturbances (Depression)
Common symptoms: increase in depressed mood and anxious thoughts. There is a big overlap between symptoms of depression and concussion - it is important to consider your history with depression, anxiety, and mood disorders and check in with your doctor about your mood and emotional developments during your recovery.
Treatment Providers: Psychologist, Naturopath for hormones & diet, Counselors/Therapists who specialize in depression, anxiety, trauma, even EMDR.
C: Cervical
Common symptoms: neck pain, headaches, dizziness, balance difficulties. There is also a big overlap of whiplash and concussion symptoms, so it is important to have a physical assessment of the cervical spine and neck range of motion after concussion.
Treatment Providers: Physical Therapist, Chiropractor, Osteopath.
H: Headaches
This is the most common symptom reported after concussion! There are multiple types of headaches and treatments outlined below. This is not an exhaustive resource.
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Post-concussive
- pressure/pain increases typically front or both sides of head as you exceed your brain’s capacity
- Addressed by implementing planning and pacing (such as the spoon theory) for your cognitive tasks typically with an occupational therapist or speech therapist
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Cervicogenic
- pain originating from neck muscles or joints
- Can be treated by a physician, physical therapist or chiropractor
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Occipital neuralgia
- pain originates from the occipital nerve at the base of your skull/back of neck
- Often associated with cluster headaches
- Can be treated by physician, physical therapist, chiropractor
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Inflammatory
- dull, aching head pain that can be similar to migraine
- chronic inflammation issues can be addressed with anti-inflammatory diet
- Can be treated by physician, naturopath
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Sinus/Allergy/Ocular
- pressure/pain around eyes and/or front of face, may be confused with migraine
- Can be treated by physician, physical therapist, optometrist, chiropractor
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Migraine
- light & sound sensitivity, can last for days, may or may not have an aura
- Causes may be genetic, hormonal, neurological, inflammatory, musculoskeletal
- Can be treated by physician, physical therapist, chiropractor
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Tension
- pressure, tight band around head
- Causes can be postural, stress, poor sleep
- A common diagnosis that blends with other headache types listed above
- Can be treated by a physician, physical therapist, psychologist
C: Cardiovascular
Common symptoms: Exercise intolerance, heart rate problems, fatigue, autonomic system anomalies (dysautonomia), and POTS (postural orthostatic tachycardia syndrome).
Treatment Providers: Medical Doctor, Physical Therapist, Chiropractor.
V: Vestibular
Common symptoms: dizziness, vertigo, balance problems. Often paired with visual symptoms associated with the oculomotor manifestations.
Treatment Providers: Vestibular Therapist, or an Occupational or Physical Therapist who have training in vestibular therapy.
**The 7 Clinical Phenotypes of Concussions article was written in 2017 and our knowledge about concussion and brain injury recovery continues to evolve and improve. Find the PDF here.